Purpose :
Keratoconus is a progressive corneal disease with thinning and scarring of the cornea. Diagnostic and treatment options have changed dramatically over the recent years. The benefits from these improvements are poorly investigated to date. We report the monocentric keratoconus registry of one of the largest tertiary care eye hospitals in Germany. Purpose of this registry is to enable further analyses that help to characterize the course of the disease.

Methods :
We evaluated all our computerized charts from 2007 to present for the key words keratoconus, corneal ectasia and keratoglobus. We manually excluded all false positives. At the time of first presentation, each eye was classified into one out of four categories: suspect, early disease, late disease, state following keratoplasty. Suspects included patients with a suspicious topography but not enough proof for the diagnosis of keratoconus. Early disease classification was used for patients with keratometric evidence of keratoconus but no signs of a late disease like corneal scarring, visual impairment or pronounced thinning of the cornea. All eyes that had already undergone any form of keratoplasty were classified as state following keratoplasty.

Results :
We included 3681 eyes from 1841 patients. Longest follow-up was up to 40 years. 378 eyes were classified as suspects. Here, median follow up was 6 months and median patient age was 34 years, 44% of the suspects were females. 1930 eyes were classified as early disease. Median follow up was 0.45 years and median patient age 35 years, 29% of these patients were females. 968 eyes were classified as late disease. Here, median follow up was 1.3 years and median patient age 39 years, 30% of the patients were females. 405 eyes already had undergone keratoplasty at the first visit. In this group mean follow up was 2.1 years; median patient age was 51 years, 28% of these patients were females. Patient age and male to female ratios differed statistically significantly between all groups (p<0.001).

Conclusions :
Our registry reveals strong associations between a high patient age and a further progression of keratoconus. There are fewer female patients in the groups with proven keratoconus. Our registry has the potential to improve the understanding of the natural course of keratoconus. Further cross sectional and longitudinal analyses will help to characterize risk factors for progression.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.